(LML) Treatment of Trophic Foot Ulcers in Leprosy

Leprosy Mailing List – March 29,  2018

Ref.:    (LML)  Treatment of Trophic Foot Ulcers in Leprosy

From:  Ben Naafs, Munnekeburen, the Netheralnds

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Dear Colleagues,

This paper was send to us by José Augusto da Costa Nery, Rio de Janeiro. It may serve to start a discussion on foot ulcer treatment and the importance of controlled trials. We must realise that nearly all treatment works thanks to the extra attention the patient given.

The treatment of ulcers with polyhexanide solution is well known for infected wounds and controlled trials are rare. With foot ulcers stretch, pressure and tangential forces are important causatives for ulcers and prevent the healing. Released, from these pressures nearly all wounds heal provided no osteomyelitis is underneath.

We hope to hear your experience and may be you have done controlled trials that are not published but are valuable sharing.

Best wishes,

Ben Naafs

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

(LML) The true magnitude of leprosy

 

Leprosy Mailing List – March 15,  2018

Ref.:   (LML) The true magnitude of leprosy

From:  Joel Almeida, Mumbai and London

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Dear Pieter,

 

Recent reports of sample surveys are informative.

 

A national sample survey in India reported that there were 330,000 previously undetected cases of leprosy in the country. Three tiers of experts were used for diagnosis. These cases were in addition to about 125,000 new cases detected by the national programme each year. The magnitude of leprosy in India is several times greater than previously reported.

 

Therefore, many more people in India are at risk of permanent nerve damage, before during and after MDT, than previously reported. Unfortunately, there has been a huge reduction in trained leprosy workers who can monitor nerves during MDT. This exposes the people of India to unnecessary permanent disfigurement from leprosy.

 

It would be good to remedy this situation.

 

The first step is to acknowledge that the magnitude of leprosy in India is several times greater than that reported to WHO. Far from declining, leprosy appears to be increasing as suggested by the doubling of newly detected cases with visible deformity, at diagnosis, in the decade following 2005-6.

 

The next is to raise adequate national and international finance for services to avert permanent disfigurement during and after MDT.

 

Further, it would be good to expand the whole cake of finance for leprosy so that all useful strands of activity, from training to research to prevention to frontline services to better inclusion of those with disfigurements, can be ramped up.

 

Perhaps most importantly, a whole new generation of talent needs to be attracted to leprosy work to correct past errors and open new possibilities. 

 

The situation in the Amazon region of Brazil might be even more serious. A recent sample survey of all schools in Manaus reported a prevalence of leprosy of 12 per 10,000 among schoolchildren. That's described as being 17 times higher than the registered rate.

 

It might be wise to put aside pretences about the decline of leprosy and prepare for the marathon ahead of us. Meanwhile, it would be good to prevent permanent disfigurement among the ordinary people who are paying the price for the past errors of others.

 

What we say to the world about leprosy needs to change, so that the magnitude of the problem is more accurately understood. The world will respond adequately. It tends to do so, once knowledge and understanding grow.

 

 

Joel Almeida

 

 

References

 

1. Katoch K, Aggarwal A, Yadav VS, Pandey A. National sample survey to assess the new case disease burden of leprosy in India. Indian J. Med. Res. 2017. 146(5):585-605

 

2. Pedrosa VL, Dias LC, Galban E, Leturiondo A, Palheta J Jr, Santos M, et al. (2018) Leprosy among schoolchildren in the Amazon region: A cross-sectional study of active search and possible source of infection by contact tracing. PLoS Negl Trop Dis 12(2): e0006261. https://doi.org/10.1371/journal.pntd.0006261

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

 

 

(LML) New publications on cross-cutting issues and NTDs – March 2018

Leprosy Mailing List – March 13,  2018 Ref.: (LML) New publications on cross-cutting issues and NTDs – March 2018   From:  Ilse Egers, Amsterdam, the Netherlands Dear Colleagues,   The newsletter provides you with a selection of news items and recent publications on cross-cutting issues in NTDs. Our starting point is to add articles covering a wide variety of issues. Unfortunately, this is not always possible due to a limited diversity in and shortage of articles on cross-cutting issues and NTDs. Feel free to contact us with any questions (infontd@leprastichting.nl)  or to receive the PDF if a link to the full text is not included. Our document delivery service is free! Ilse Egers InfoNTD Information officer       News   Deworming: every girl and every woman has the right to be treated. Read more   Yaws: strict compliance with WHO's Morges strategy critical to achieve eradication. Read more   Three Scientists Awarded Maiden ARNTD Internal Small Grants Three scientists have emerged as winners in the first African Research Network for Neglected Tropical Diseases (ARNTD) internal Small Grants Program (iSGP). With one of the ARNTD's strategic objectives being "to stimulate research and strengthen the capacity required in Africa", the Network's Management Board dedicated an amount of EUR 20,000 to the iSGP from funds donated by the foundations which supported the initial set-up of the ARNTD. Two of the iSGP projects to be funded cover NTDs: lymphatic filariasis and leishmaniasis. Read more           New publications       Assessing the feasibility of integration of self-care for filarial lymphoedema into existing community leprosy self-help groups in Nepal. Pryce J, Mableson HE, Choudhary R, et al. BMC Public Health. 2018; 18(1):201. Abstract Lymphatic filariasis (LF) and leprosy are disabling infectious diseases endemic in Nepal. LF infection can lead to lymphoedema and hydrocoele, while secondary effects of leprosy infection include impairments to hands, eyes and feet. The disabling effects of both conditions can be managed through self-care and the supportive effects of self-help groups (SHGs). The aim of this study was to determine the feasibility of integrating LF affected people into existing leprosy SHGs in Nepal. Download PDF Perceived causes and risk factors of Buruli ulcer among patients at Agogo Presbyterian hospital in Ashanti Region of Ghana. Anokye R, Acheampong E, Mprah WK, et al. BMC Res Notes. 2018; 11(1):64. Abstract The incidence of Buruli ulcer has been recorded in about 30 countries globally and Africa seems to be the most affected area. The study sought to determine perceived causes and risk factors of Buruli ulcer among patients who visit the Agogo hospital in Asante-Akim North District in the Ashanti region of Ghana. A descriptive study design was adopted using a simple random sampling technique to select 400 patients attending The Presbyterian Hospital at Agogo. Download PDF Combined effectiveness of anthelmintic chemotherapy and WASH among HIV-infected adults. Means AR, van Lieshout L, Brienen E, et al. PLoS Negl Trop Dis. 2018; 12(1):e0005955. Abstract Current global helminth control guidelines focus on regular deworming of targeted populations for morbidity control. However, water, sanitation, and hygiene (WASH) interventions may also be important for reducing helminth transmission. We evaluated the impact of different potential helminth protective packages on infection prevalence, including repeated treatment with albendazole and praziquantel with and without WASH access. Download PDF Sanitation and water supply coverage thresholds associated with active trachoma: Modeling cross-sectional data from 13 countries. Garn JV, Boisson S, Willis R, et al. PLoS Negl Trop Dis. 2018; 12(1):e0006110. Abstract Facial cleanliness and sanitation are postulated to reduce trachoma transmission, but there are no previous data on community-level herd protection thresholds. We characterize associations between active trachoma, access to improved sanitation facilities, and access to improved water sources for the purpose of face washing, with the aim of estimating community-level or herd protection thresholds. Download PDF "Cross-border collaboration in onchocerciasis elimination in Uganda: progress, challenges and opportunities from 2008 to 2013." Lakwo T, Ukety T, Bakajika D, et al. Global Health. 2018; 14:16. Abstract Until recently onchocerciasis was prevalent in 37 out of 112 districts of Uganda with at least 3.8 million people at risk of contracting the disease, but following the launching of community-directed treatment with ivermectin (CDTI) in 1996 and the adoption of an onchocerciasis elimination policy in 2007, the country has made significant progress in combating the disease. This paper summarises the experience of Uganda in addressing cross-border issues on onchocerciasis elimination with DRC. Download PDF Economic evaluations of lymphatic filariasis interventions: a systematic review and research needs. Gedge LM, Bettis AA, Bradley MH, et al. Parasit Vectors. 2018; 11(1):75. Abstract In 2000, the World Health Organization established the Global Programme to Eliminate Lymphatic Filariasis (GPELF), with the goal of eliminating the disease as a public health problem by 2020. Since the start of the programme, a cumulative total of 6.2 billion treatments have been delivered to affected populations - with more than 556 million people treated in 2015 alone. In this paper, we perform a rigorous systematic review of the economic evaluations of lymphatic filariasis interventions have been conducted. Download PDF Elimination of lymphatic filariasis in west African urban areas: is implementation of mass drug administration necessary? Koudou BG, de Souza DK, Biritwum N-K, et al. Lancet Infect Dis. 2018. Abstract Lymphatic filariasis in Africa is caused by the parasite Wuchereria bancrofti and remains a major cause of morbidity and disability in 74 countries globally. A key strategy of the Global Programme for the Elimination of Lymphatic Filariasis, which has a target elimination date of 2020, is the treatment of entire endemic communities through mass drug administration of albendazole in combination with either ivermectin or diethylcarbamazine. Read more Leishmaniasis in Sri Lanka: spatial distribution and seasonal variations from 2009 to 2016. Galgamuwa LS, Dharmaratne SD, Iddawela D. Parasit Vectors. 2018; 11(1):60. Abstract Leishmaniasis is listed as one of the eight neglected tropical diseases by the World Health Organization and the number of cases in endemic areas has seen a sharp rise in the past decade. In Sri Lanka, leishmaniasis is considered as a notifiable disease from 2008 and has seen a rising trend of incidence since then. This is the first study describing the burden, seasonal variation and spatial distribution of leishmaniasis in Sri Lanka since the disease has been included as a notifiable disease. Download PDF PLOS NTDs celebrates our 10th anniversary: Looking forward to the next decade. Aksoy S, Walson JL. PLoS Negl Trop Dis. 2018; 12(1):e0006176. Download PDF Assessment of WASH scenarios in urban and rural schools of a small city in the Brazilian Amazon. Borges-Pedro JP, Müller P, Nunes AP, et al. Acta Amazon. 2018; 48(1):75-82. Abstract This study analyzed environmental aspects of county and state managed public schools within Tefé county in the Brazilian Amazon, using the WASH concept (Water, Sanitation and Hygiene) developed by UNICEF and OMS. WASH is a strategy used since 1995, when child mortality rates were on the rise. Research was conducted using a questionnaire applied to employees of 19 primary and secondary schools, and based on WASH principles. Download PDF Inferring the risk factors behind the geographical spread and transmission of Zika in the Americas. Gardner LM, Bóta A, Gangavarapu K, et al. PLoS Negl Trop Dis. 2018; 12(1):e0006194. Abstract An unprecedented Zika virus epidemic occurred in the Americas during 2015-2016. Our study complements several recent studies which have mapped epidemiological elements of Zika, by introducing a newly proposed methodology to simultaneously estimate the contribution of various risk factors for geographic spread resulting in local transmission and to compute the risk of spread (or re-introductions) between each pair of regions. Download PDF Geographical distribution of soil transmitted helminths and the effects of community type in South Asia and South East Asia - A systematic review. Silver ZA, Kaliappan SP, Samuel P, et al. PLoS Negl Trop Dis. 2018; 12(1):e0006153. Abstract Soil-transmitted helminth (STH) infections are among the most prevalent neglected tropical diseases (NTD) worldwide. Since the publication of the WHO road map to combat NTD in 2012, there has been a renewed commitment to control STH. In this study, we analysed the geographical distribution and effect of community type on prevalence of hookworm, Trichuris and Ascaris in south Asia and south east Asia. Download PDF Risk factors for Mycobacterium ulcerans infection (Buruli Ulcer) in Togo ─ a case-control study in Zio and Yoto districts of the maritime region. Maman I, Tchacondo T, Kere AB, et al. BMC Infect. Dis. 2018; 18(1):48. Abstract Buruli ulcer (BU) is a neglected mycobacterial skin infection caused by Mycobacterium ulcerans. This disease mostly affects poor rural populations, especially in areas with low hygiene standards and sanitation coverage. The objective of this study was to identify these risk factors in the districts of Zio and Yoto of the Maritime Region in Togo. Download PDF Interventions to maximize facial cleanliness and achieve environmental improvement for trachoma elimination: A review of the grey literature. Delea MG, Solomon H, Solomon AW, et al. PLoS Negl Trop Dis. 2018; 12(1):e0006178. Abstract Efforts are underway to scale-up the facial cleanliness and environmental improvement (F&E) components of the World Health Organization's SAFE strategy for elimination of trachoma as a public health problem. Improving understanding of the F&E intervention landscape could inform advancements prior to scale-up, and lead to more effective and sustained behavior change. Download PDF Podoconiosis: Nonfilarial endemic elephantiasis. Olanipekun T, Qin H, Fransua M. Eur J Intern Med. 2018. Read more Preventive chemotherapy to control soil-transmitted helminthiasis averted more than 500 000 DALYs in 2015. Montresor A, Trouleau W, Mupfasoni D, et al. Trans. R. Soc. Trop. Med. Hyg. 2018. Abstract Preventive chemotherapy (PC), the large-scale administration of anthelminthics, is recommended by the World Health Organization (WHO) for the control of soil-transmitted helminthiasis (STH). Since 2010, donated anthelminthics for STH have boosted the implementation of PC programmes in children, achieving global coverage of more than 60% in 2015. The WHO Global Health Estimates attribute an annual loss of over 3.3 million disability-adjusted life-years (DALYs) to STH. The aim of this study is to estimate the impact of PC programmes on child morbidity. Read more     Events ISNTD festival March 27th 2018 The ISNTD Festival brings together the best in communication, arts, entertainment and science to help complex public health messages reach patients, the public and global health professionals worldwide. Read more

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

(LML) Infolep leprosy publications up date – March 2018

Leprosy Mailing List – March 9,  2018

Ref.:    (LML) Infolep leprosy publications up date – March 2018

From:  Jiske Erlings, Amsterdam, the Netherlands

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Dear colleagues,  Below you will find this month's overview of new publications on leprosy and related subjects. Feel free to contact me to receive the full text versions if a link to the full text is not included or for assistance with your literature research. You are also invited to send us your publications on leprosy or material on leprosy in your language for inclusion in the portal. With warm regards, Jiske Erlings, j.erlings@leprastichting.nl Infolep Information officer

 

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Highlighted publications

 

 

BCG vaccines: WHO position paper  Wkly Epidemiol Rec. 2018 Feb 23;93(8):73-96. English, French. Download PDF Ahead of International Women's Day, 8th March, Lepra has published new research which found which found 30% more women living with leprosy in Bihar, India, than the Indian government. Download PDF Infolep International Women's Day dossier on women & girls with leprosy https://www.leprosy-information.org/keytopic/girls-and-women-leprosy

 

 

New publications

 

 

Lucio's phenomenon: a life-threatening medical emergency. Bernardes Filho F, Pess D, Akabane AL, et al. Int J Infect Dis. 2018 Feb 21. Download PDF   Leprosy of the hard palate: A rare case report. Bommanavar S, Ingale Y, Ingale M, et al. J Oral Maxillofac Pathol. 2018; 22(4):121-125. Download PDF   Neglected Tropical Disease Control - The Case for Adaptive, Location-specific Solutions. Booth M, Clements A. Trends Parasitol. 2018 Feb 27. pii: S1471-4922(18)30010-2. Read abstract   Oral history and memories of Hansen's disease patients in two Colombian leper colonies: life trajectories, conflicts and resistance strategies. Botero-Jaramillo N, Mora-Blanco J, Quesada-Jiménez ND. Hist Cienc Saude Manguinhos. 2017; 24(4):989-1008. Download PDF   Antimicrobial resistance in leprosy: results of the first prospective open survey conducted by a WHO surveillance network for the period 2009-2015. Cambau E, Saunderson P, Matsuoka M, et al. Clin Microbiol Infect. 2018 Feb 26. pii: S1198-743X(18)30197-6. Download PDF   Vaccines for leprosy and tuberculosis: Opportunities for shared research, development and application. Coppola M, van den Eeden SJ, Robbins N, et al. Front Immunol. 2018. Read abstract   Experimental leprosy granulomas. Crawford CL. J. Infect. Dis. 2018. Read abstract   Measuring social exclusion in healthcare settings: a scoping review. O'Donnell P, O'Donovan D, Elmusharaf KInt. J Equity Health. 2018 Feb 2;17(1):15. Download PDF   Assessment of knowledge and awareness about leprosy among medical college students in Mewat region of Haryana. Garima G, Sharma A, Sharma S, et al. IJCBR. 2018; 4(1):1-4. Download PDF   Quality of life of people affected with leprosy disability living in Purulia, West Bengal. Govindharaj P, Srinivasan S, Darlong J. Int J Health Sci Res. 2018; 8(2):221-225. Download PDF  Tuberculoid leprosy with type 1 lepra reaction. Hanumanthayya K, Balasubrahmanyam G, Sohila K, et al. RGUHS J Med Sciences. 2018; 8(1):32-33. Download PDF   Hansen's neuritis revisited - A clinicopathological study. Jaiswal N, Chakraborti S, Nayak K, et al. J Neurosci Rural Pract. 2018 Jan-Mar;9(1):42-55. Download PDF   National sample survey to assess the new case disease burden of leprosy in India. Katoch K, Aggarwal A, Yadav VS, et al. Indian J Med Res. 2017 Nov;146(5):585-605. Download PDF   Enriched whole genome sequencing identified compensatory mutations in the RNA polymerase gene of rifampicin-resistant Mycobacterium leprae strains. Lavania M, Singh I, Turankar RP, et al. Infect Drug Resist. 2018; 11:169-175. Download PDF   The distribution of district-level leprosy incidence in India is geometric-stable, consistent with subcriticality. Lietman TM, Worden L, Liu F, et al. Epidemics. 2018:17. Download PDF   Genotyping comparison of Mycobacterium leprae isolates by VNTR analysis from nasal samples in a Brazilian endemic region. Lima LNC, Frota CC, Suffys PN, et al. Pathog Glob Health. 2017:1-7. Read abstract   Control actions on leprosy in primary health care in a Brazilian capital: Profile of professionals and users. Lustosa AA, Barboza NA, Silva Barbosa YGD, et al. Int Arch Med. 2018; 11(12):1-10. Download PDF   Serum Levels of Migration Inhibitory Factor (MIF) and In Situ Expression of MIF and Its Receptor CD74 in Lepromatous Leprosy Patients: A Preliminary Report. Martinez-Guzman MA, Alvarado-Navarro A, Delgado-Rizo V, et al. Front Immunol. 2018 Feb 13;9:246. Download PDF   Tegumentary leishmaniasis and coinfections other than HIV. Martínez DY, Verdonck K, Kaye PM, et al. PLoS Negl Trop Dis. 2018 Mar 1;12(3):e0006125. Download PDF    Evaluation of safety tool for ambulatory leprosy patients at risk of adverse outcome. MacRae C, Kopalakrishnan S, Faust L, et al. Trop Dis Travel Med Vaccines. 2018 Mar 2;4:1. Download PDF   Ribonucleotide reductase as a drug target against drug resistance Mycobacterium leprae: A molecular docking study. Mohanty PS, Bansal AK, Naaz F, et al. Infect Genet Evol. 2018 Feb 15;60:58-65. Read abstract   [Leprosy patients' efforts to prevent increasing degrees of disability] Mulyadi A, Sepdianto TC, Mitayasari E. JNK JOURNAL. 2018; 4(3):186-191. Download PDF   Determinants of disability in patients with leprosy at Kelet Hospital, Central Java. Nadhiroh U, Dharmawan R, Murti B. JEPH. 2018; 3(2):143-252. Download PDF   Complement C1q expression in Erythema nodosum leprosum. Negera E, Walker SL, Lemma T, et al. PLoS Negl Trop Dis. 2018 Mar 2;12(3):e0006321. Download PDF   The Effects of Prednisolone Treatment on Cytokine Expression in Patients with Erythema Nodosum Leprosum Reactions. Negera E, Walker SL, Bobosha K, et al. Front Immunol. 2018 Feb 9;9:189. Download PDF   Leprosy among schoolchildren in the Amazon region: A cross-sectional study of active search and possible source of infection by contact tracing. Pedrosa VL, Dias LC, Galban E, et al. PLoS Negl Trop Dis. 2018; 12(2):e0006261. Download PDF   Clinical and histopathological response to multidrug therapy in paucibacillary leprosy at the end of 6 months: A prospective observational study from eastern India. Podder I, Saha A, Bandyopadhyay D. Indian J Dermatol. 2018; 63(1):47-52. Download PDF   miRNome expression analysis reveals new players on leprosy immune physiopathology. Salgado CG, Pinto P, Bouth RC, et al. Front Immunol. 2018. Read abstract   Cytological diagnosis of erythema nodosum leprosum in clinically unsuspected cases: A report of two cases. Semwal S, Joshi D, Goel G, et al. J Cytol. 2018; 35(1):63-65. Download PDF   Elimination of leprosy in India: An analysis. Sengupta U. Indian J Dermatol Venereol Leprol. 2018; 84(2):131-136. Download PDF   Non-contact ulcer area calculation system for neuropathic foot ulcer. Shah P, Mahajan S, Nageswaran S, et al. Foot Ankle Surg. 2017 Aug 11. pii: S1268-7731(17)31272-9. Read abstract   Host lipid mediators in leprosy: the hypothesized contributions to pathogenesis. Silva CAM, Belisle JT. Front Immunol. 2018 Feb 2;9:134. Download PDF   Erythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition. do Socorro Silva Costa P, Fraga LR, Kowalski TW, et al. Acta Trop. 2018. Read abstract   Leprosy and gender in Brazil: trends in an endemic area of the Northeast region, 2001-2014. Souza EA, Ferreira AF, Boigny RN, et al. Rev Saude Publica. 2018;52:20. Download PDF   [Programmatic vulnerability in leprosy control: gender-related patterns in Bahia State, Brazil]. de Souza EA, Boigny RN, Ferreira AF, et al. Cad Saude Publica. 2018; 34(1):e00196216. Download PDF   Community knowledge, perceptions and attitudes regarding leprosy in rural Cameroon: The case of Ekondotiti and Mbonge health districts in the South-west Region. Tabah EN, Nsagha DS, Bissek A-CZ-K, et al. PLoS Negl Trop Dis. 2018; 12(2):e0006233. Download PDF   A Comparative Analysis of Economic Cost of Podoconiosis and Leprosy on Affected Households in the Northwest Region of Cameroon. Tembei AM, Kengne Ouaffo JA, Ngoh EA, et al. Am J Trop Med Hyg. 2018 Feb 19. Download PDF   Final leprosy push: Out of society. Thangaraju P, Venkatesan S, Showkath Ali MK. Indian J Community Med. 2018; 43(1):58-59. Download PDF   Anti-phospholipid syndrome in seven leprosy patients with thrombotic events on corticosteroid and/or thalidomide regimen: insights on genetic and laboratory profiles. Vernal S, Brochado MJF, Bueno-Filho R, Rev Soc Bras Med Trop. 2018 Jan-Feb;51(1):99-104. Download PDF   Extensive lepromatous lymphadenitis preceding lesions on the face and earlobes: An unusual presentation of leprosy in Singapore. Yang  Y S, Leong  M S, Kasunuran  M T, et al. Case Rep Dermatol. 2018; 10(1):35-40. Download PDF

 

 

Journals & Newsletters

 

 

Disability, CBR & Inclusive Development: http://dcidj.org/ Hansenologia Internationalis: http://www.ilsl.br/revista/atual.php Indian Journal of Leprosy: http://www.ijl.org.in/index.html  Leprosy Review: https://www.lepra.org.uk/Pages/FAQs/Category/volume-88 Leprosy Review Repository (1928-2001) : http://leprev.ilsl.br/arquivo.php Plos Neglected Tropical Diseases: http://journals.plos.org/plosntds/   Revista de Leprología: http://www.leprosy-information.org/resource/revista-de-leprologia   WHO Goodwill Ambassador's Newsletter for the elimination of leprosy: http://www.smhf.or.jp/e/ambassador/index.html

 

 

Websites & Services

 

 

Global Leprosy Programme http://www.searo.who.int/entity/global_leprosy_programme/en/ LML - Leprosy Mailing List - a free moderated email list that allows all persons interested in this theme to share ideas, information, experiences and questions. http://leprosymailinglist.blogspot.nl/ InfoNTD - Information on cross-cutting issues in Neglected Tropical Diseases (NTDs) https://www.infontd.org/

 

 

infolep   Infolep portal   Like us   @Infolep

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com